If you swallow a foreign object, it will usually pass through your digestive system uneventfully. But some objects can lodge in your esophagus, the tube that connects your throat and stomach. If an object is stuck in your esophagus, you may need to have it removed, especially if it is:
- A pointed object, which should be removed as quickly as possible to avoid further injury to the esophageal lining
- A tiny watch- or calculator-type button battery, which can rapidly cause nearby tissue injury and should be removed from the esophagus without delay
If a person who has swallowed an object is coughing forcefully, encourage him or her to continue coughing and do not interfere. If a swallowed object blocks the airway and the person's condition worsens — the cough becomes silent or breathing becomes more difficult — the American Red Cross recommends the five-and-five approach to first aid:
- Give 5 back blows. First, deliver five back blows between the person's shoulder blades with the heel of your hand.
- Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver). Abdominal thrusts may injure infants. Use chest compressions instead.
- Alternate between 5 back blows and 5 abdominal thrusts until the blockage is dislodged.
If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.
If the person becomes unconscious, help him or her to the ground and begin CPR. After attempted rescue breaths, check the mouth for an object and if visible remove it. Do not perform a blind finger sweep because this could push an object farther into the airway.
The American Heart Association does not teach the back-blow technique, only the abdominal thrust procedures. It's OK not to use back blows if you have not learned the back-blow technique. Both approaches are acceptable.
- Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.
- Make a fist with 1 hand. Position it slightly above the person's navel.
- Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
- Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle.
A modified version of the technique is sometimes taught for use with pregnant or obese people. The rescuer places his or her hand in the center of the chest to compress, rather than in the abdomen.
If you're choking and alone, call 911 or your local emergency number immediately. You can't perform back blows on yourself. But you can perform abdominal thrusts.
- Place a fist slightly above your navel.
- Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
- Shove your fist inward and upward.
Sept. 20, 2014
- Swallowed a button battery? National Capital Poison Center. http://www.poison.org/battery. Accessed Aug. 14, 2014.
- First Aid/CPR/AED Participant's Manual. American Red Cross. http://editiondigital.net/publication/?i=64159. Accessed Aug. 14, 2014.
- What to do in a medical emergency: Choking (Heimlich maneuver). American College of Emergency Physicians. http://www.emergencycareforyou.org/EmergencyManual/WhatToDoInMedicalEmergency/Default.aspx?id=224. Accessed Aug. 14, 2014.
- Berg RA, et al. Part 5: Adult basic life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(suppl 3):S685.
- Berg RA, et al. Part 13: Pediatric basic life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(suppl 3):S862.
- Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: The McGraw Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=40. Accessed Aug. 25, 2014.